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Objective To evaluate the effect of iodine supplementation on improvement of developmental quotient (DQ) at the critical period of infant brain development.Methods Pregnant,lactating women and infants less than 3 years old were supplemented with iodized oil in Linxia Hui Autonomous Prefecture(Linxia Prefecture) Gansu Province in 2006-2010.Before and after the intervention(2006,2007-2010),five townships were randomly selected in the north,the south,the east,the west and the center of eight counties(cities) of Linxia.One village was chosen from each of those townships and 20 infants,20 pregnant women and 20 lactating women were randomly selected in each village(insufficient was made up from the neighboring villages).Urinary iodine(UI) level of the infants,pregnant and lactating women were determined by arsenic cerium catalytic spectrophotometry.DQ value of infants was measured before and after supplementation of iodized oil in 2006 and 2010.UI value of pregnant,lactating women and infants was monitored every year after iodine supplementation.Results Before iodine supplementation(2006),the median UI level of pregnant,lactating women and infants was 89.28,84.85,107.3 μg/L,respectively.After iodine supplementation,the medians UI level in 2007,2008,2009 and 2010 were,respectively,pregnant women:136.0,187.8,118.2,175.8 μg/L; lactating women:135.2,159.8,187.5,163.5 μ g/L; infants:139.6,174.7,190.7,168.4 μg/L.Before iodine supplementation,the DQ value of infants was 92.8 ± 16.3,and the average score of gross motor,fine motor,adaptive capacity,language and social behavior was 93.7 ± 20.0,91.4 ± 20.0,92.4 ± 19.0,90.3 ± 20.0,96.4 ± 22.1,respectively.After iodine supplementation,the DQ value of infants was 104.3 ± 13.8,and the average score of gross motor,fine motor,adaptive capacity,language and social behavior was 104.8 ± 21.5,104.1 ± 17.2,104.8 ± 16.1,99.9 ± 19.1,108.0 ± 22.7,respectively,which were higher than that before iodine supplementation (t =-10.43,-10.77,-13.78,-14.28,-9.96,-15.33,all P ＜ 0.01).Conclusions Iodine deficiency at the critical period of brain development can affect the intellectual development of infants and young children at all functional areas of intelligence.Iodine supplementation at the critical period of brain development can prevent mental retardation caused by iodine deficiency disorders.
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Objective To evaluate the effect of health education on the target population of iodine deficiency disorders (IDD) in Linxia Hui autonomous prefecture.Methods During 2006-2010,IDD health education was carried out in the target population of Linxia Hui autonomous prefecture,and IDD knowledge of 5th grade pupil and 20-50 years old child-bearing women were surveyed by stratified sampling and questionnaire survey methods to evaluate the effect of health education.Results After health education,IDD knowledge passing rate rose from 55.6％ (548/986) and 18.0％(118/657) to 90.0％(1103/1225) and 86.2％(687/797) among pupils and women,respectively.The awareness rates of iodine deficiency in causing goiter,mental retardation and birth born silly children,and the key role of iodized salt in controling IDD were increased from 79.2％ (781/986),76.5％ (754/986),51.7％ (510/986) and 82.3％ (811/986) to 88.8％ (1088/1225),85.6％ (1049/1225),68.7％ (842/1225) and 90.0％ (1103/1225) among pupils,and from 48.6％ (319/657),28.3％ (186/657),15.4％ (101/657) and 39.6％ (260/657) to 86.2％ (687/797),70.0％ (558/797),46.3％ (369/797) and 87.3％ (696/797) among women,and all the difference were significant,respectively.Belief rate held by students that health education can prevent iodine deficiency disorders was 87.3％ (1069/1225),and 52.9％ (648/1225) of the students told their parents about IDD.The rate of consciously purchase of qualified iodized salt was 87.1％ (694/797) after health education among women of childbearing age,and the consumption rate of iodized salt was 64.6％(515/797).More than 90％ of the people in relevant departments knew iodine deficiency disorders related knowledge,in particular,had a clear understanding of intellectual hazards caused by iodine deficiency,and actively supported and participated in health education in the prevention and control of iodine deficiency disorders.Conclusions Comprehensive health education measures taken through schools and religious organizations has promoted a shift in the behavior,beliefs and attitudes of its consciously purchase and consumption of iodized salt,and integrated knowledge,attitude and practice (KAP).It is a good model of health education through religious organizations in ethnic minority areas.It has promoted the health education feasibility and accessibility,and the effect is more durable.
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Objective To study the iodine nutritional status of population living in Tibetan pastoral areas,in order to provide a scientific basis for prevention and control of iodine deficiency disorders.Methods Drinking water samples were collected to test iodine content in agricultural town(Kajiaman) and pastoral area(Zuogaiduoma town) of Hezuo in Gannan Tibetan autonomous prefecture.Thirty of child-bearing age,pregnant and breastfeeding women were selected,respectively,and 90 male adults aged 20-50 from these families(1 from each family) and 90 children aged 8-10 (30 people in each age group) from local schools were randomly sampled at the same time,and urinary iodine (UI) was measured randomly.Edible salt and main food samples were collected to test iodine content from the 10 families of the three types of women,respectively,and they were asked to recall its family intake of food species in the past 24 h excluding spices.The water iodine was determined using arseniccerium redox method (GB/T 5750.1-2006) ; UI with ammonium persulfate digestion-arsenic cerium catalytic spectrophotometric method (WS/T 107-2006) ; salt iodine used direct determination method(GB/T 13025.7-1999); and food iodine with alkali the gray arsenic cerium contact colorimetry.All these work were done in May,2011.Results The average of water iodine was (1.63 ± 0.14)μg/L in agricultural areas and (2.08 ±1.90)μg/Lin pastoral areas of the 10 water samples tested,respectively.The median urinary iodine(MUI) among women of pregnant,lactating and child-bearing age,male adults and children was 141.99,126.65,253.33,258.07,191.0μg/L,respectively,in agricultural areas and 137.26,97.36,126.16,159.48,285.07 μg/L,respectively,in pastoral areas.The difference of MUI in lactating,male adults and children between pastoral and agricultural areas was statistically significant.The proportion of UI ＜ 50 μg/L was less than 20％,and ＜ 100 μg/L was less than 50％ among all population except lactating woman and pregnant women in pastoral areas.The iodized salt coverage rate was 100％(30/30) in agricultural areas and 90％(27/30) in pastoral areas,and the salt iodine was (32.1 ± 7.8)mg/kg in agricultural areas and (32.3 ± 6.0)mg/kg in pastoral areas,respectively.The food structure in agricultural areas was mainly potato,naked oat fruit,cabbage and so on,the average dietary iodine content was 285.7 μg/kg,and in pastoral areas was mainly chow mein,wheat flour,ghee,yogurt,barley and so on,the average dietary iodine content was 51.1 μg/kg.Conclusions There is no iodine deficiency in general in the population in Tibetan areas with low water iodine.However,iodine nutrition of pregnant women can not be guaranteed.It is recommended that classified guidance measures be taken to ensure the sustainable elimination of iodine deficiency disorders in the Tibetan minority areas.
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Objective To investigate the relationship between iodine nutrition and growth/ development in infants at the key period of brain development.Methods All women from pregnancy to the end of lactation and the weaning infants within 3 years in the Linxia Hui Autonomous Prefecture (Linxia Prefecture) were added iodized oil in 2006-2010.In 2006,2010 one town was randomly selected from each of the five directions (east,south,west,north,central) of each county in Linxia Prefecture.One village was chosen from every town and 20 infants,20 pregnant women and 20 lactating women were randomly selected in each town.Urinary iodine (UI) of the infants,pregnant and lactating women were determined.DQ value,height and weight of part of infants were measured.According to the above sampling plan,UI of pregnant women,lactating women and infants had been monitored every year after intervention.0-3 infants were choosing to be control before intervention.Results UI of 1056 and 2989 0-3 infants were investigated before and after the iodine oil intervention.After the ‘iodine oil' intervention,the median UI of infants increased from 107.3 μg/L to 139.6-190.7 μg/L,the percentage of UI level that lower than 50 μg/L,decreased from 23.9％ to 6.7％-12.9％.DQ value increased from 92.8 to 104.3,the percentage of normal height and above increased from 65.0％ to 82.1％ and the percentage of the normal weight and above,increased from 59.3％ to 81.4％.The outcomes of DQ value,height and weight showed statistically significant differences,compared to the pre- intervention outcomes (P＜0.05).The median UI of pregnant and lactating women increased from 89.3 μg/L to 118.2-187.8 μg/L and from 84.9 μg/L to 135.2-187.5 μg/Lrespectively.Conclusion Infant' s growth and development were retarded when iodine deficiency existed at the key period of brain development.Intake of oral iodine oil at key period of brain development could provide adequate nutrition thus improve growth and development on infants.
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Objective To assess the improvement of intelligence quotient through an Universal Salt Iodization Supply Program,among children.Methods 3518 and 1611 children were selected from primary schools in Linxia Hui Autonomous Prefecture of Gansu in 2006 and 2010respectively.Intelligence quotient (IQ) were measured by the revised Chinese Combined Raven Test C2 (CRT-C2).Results In 2006,the average IQ of children aged 8-10 was 85.1,including 16.7％ of them with IQ≤69.The average IQ was between 80-90 in different counties and cities,with significant differences (P＜0.05).The average IQs were 92.0,90.6 and 81.8 among 8,9 and 10 years old children respectively with 10 year old' s low than those 8 and 9 year olds (P＜0.05).The average IQs of boys and girls were 84.5 and 85.6,but with no significant difference (P ＞0.05).The average IQ of children aged 8-10 in 2010 was 97.2 and 12 points higher than in 2006 (P＜0.05),but 8 IQ points (P＜0.05) less than the average level 105 from the overall of Gansu province.4.7％ of the children having an IQ≤69.IQ of children from Linxia city and Yongjing county,were up to the theoretical level of 100,with an average IQ at around 95 in other counties.The average IQs between counties or cities showed significant differences.The IQ of 8,9 year olds and 10 year olds did not present significant difference (P＞0.05),but in boys (98.8) and in girls (95.9) the difference was significant (P＜0.05).Conclusion The average IQ was close to the theoretical level (100) with the gradual implementation of universal salt iodization program,showing that the iodized salt did play a key role on children's intelligence.However,the average IQ was still lower than the average level of the whole Gansu province in 2010.
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Objective To analyze monitoring results of iodized salt and distribution characteristics of problem areas with non-iodized salt in Gansu province during 2001 - 2009 and to provide a basis to develop countermeasures to iodine deficiency disorders. Methods According to the criterion of "The National Scheme of Iodized Salt Surveillance", two levels of monitoring were carried out on production and wholesale-level(during 2001 -2007) and household-level(during 2001 - 2009). Salt iodine was determined by direct titration method (GB/T13025.7-1999), and Sichuan salt or special salt was determined with an arbitration method. Criteria for qualified iodized salt was (35 ± 15)mg/kg(20 - 50 mg/kg), and for non-iodized salt was ＜ 5 mg/kg. Results During 2001 - 2007, a total of 4900 salt samples at production and wholesale-levels were examined, with a qualification rate of 97.80% (4792/4900). Non-iodized salt rates were all below 5% in Gansu province, consumption rate of qualified iodized salt was higher than 90% after 2003. During 2001 - 2009, cities(states) with non-iodized salt problems appeared 23 times, with Linxia accounting for 39.1%(9/23), Wuwei accounting for 21.7%(5/23). During 2001 -2009, counties(districts) with non-iodized salt problem appeared 123 times, including 68 times of ethnic minorities and state poverty counties, accounting for 55.3%(68/123). During 2001 - 2005 and 2006 - 2009, ethnic minorities and state poverty counties were accounting for 49.4%(44/89) and 70.6%(24/34) in counties with non-iodized salt problem. Conclusions The quality of iodized-salt at production and wholesale level is satisfactory in Gansu province, household consumption rate of qualified iodized salt have reached national standard for eliminating iodine deficiency disorders. But ethnic minorities and state poverty counties are main regions with non-iodized salt problem,these areas will be the key areas of prevention of iodine deficiency disorders in Gansu province in the future.
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Objective To master the status in control of iodine deficiency disorders (IDD) in Gansu province and to provide the basis for development of control strategies. Methods One county which reached the national standardization of IDD elimination was selected randomly from each of 14 cities of Gansu province in 2009, then one town was selected respectively from five directions (east, south, west, north, and central) of the above selected counties. One village was chosen from every town which was selected for investigating household iodized salt and iodized salt sales network. At the same time the thyroid of children was examined, their urinary iodine (UI) was determined, the intelligence quotient(IQ) values of children were measured and health education was surveyed in one primary school which was chosen in each of the selected town. Results A total of 1420 edible salt samples were tested;the weighted iodized salt coverage rate and the weighted qualified iodized salt rate were 99.53% and 98.15 respectively. Urine samples were collected from 1761 children included in the study. The urinary iodine median was 225.87 μg/L. The urinary iodine medians were at optimal levels in five counties, over the optimal levels in seven counties and at excessive levels in two counties. A total of 3051 children aged 8 - 10 were randomly selected for thyroid examination. The weighted thyroid goiter rate(TGR) of children was 1.9%, and TGR was higher than 5% only in Hoaggu county. IQ of 2815 children was tested and the mean IQ was 105.3, except for the country of Zhuoni and Kangle, the mean IQ of other counties were over 100. The average score of health education was 3.2.Children of 57.08% (1229/2153) knew that iodine deficiency could lead to mental retardation, 71.76% (1544/2153) knew that iodine deficiency could cause thyroid goiter, 68.04%( 1465/2153 ) knew that eating iodized salt was the best method for IDD prevention and control and 61.82%(1331/2153) informed their families of the benefits of eating iodized salt. Each town had one agency selling iodized salt and each village had one more retail store with iodized salt, but 73.5%(75/102) of the stores without license for the sales. Conclusions Great progress has been made on the prevention and control of IDD in Gansu province. The qualified iodized salt consumption rate has reached the national standard for IDD elimination, TGR has decreased markedly, the urinary iodine levels in more counties are over the optimal levels and iodized salt distribution network is basically sound. But progress in health education is uneven.
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Objective To assess iodine nutrient levels of vulnerable population in Linxia Hui Autonomous Prefecture of Gansu. Methods Local pregnant, lactation, child-bearing age women and 0 - 3 years old infants were selected. The urinary iodine (UI) were determined by arsenic-Ce catalytic spectrophotometry (WS/T 107-1999) and salt iodine content was determined using direct titration method (GB/T 13025.7-1999). The development quotient (DQ) among 0 - 3 years old infants were surveyed by the scales of neuropsychologists development among 0 - 6 years old, and their body height and weight were then investigated. Results The consumption and coverage rates of iodized salt at household level were all below than 90% in 5 counties among 8 counties. The median urine iodine (MUI) among pregnant, lactation, child-beating age women and 0 - 3 years old infants were 90.17, 89.28, 84.85 and 107.28 μg/L, respectively. The UI proportion less than 50 μg/L were 29.6%(278/938), 30.7%(239/778), 32.2% (265/824), and 23.9%(252/1056), respectively. The UI proportion equal or more than 50 μg/L and less than 100 μg/L were 25.1%(235/938), 24.0%(187/778), 23.7%(195/824), 23.7%(250/1056). MUI in pregnant were all less than 150 μg/L in 8 counties, and MUI in lactation women were less than 100 μg/L in 6 counties. The DQ median of infants 0 - 3 years old was 93.0, and 59.9%(395/659), 34.4%(227/659) and 5.6%(37/659)had a DQ below middle, at middle and above middle, respectively. Forty point seven percent (266/654), 50.2%(328/654) and 9.1% (60/654) had a body height below middle,at middle and above middle, respectively. Thirty-five percent (232/663), 51.3%(340/663) and 13.7%(91/663) had a body weight below middle, at middle and above middle, respectively. Conclusions The local qualified iodized salt consumption rate and iodized salt coverage rate are still low. The urine iodine level is below than the reference value recommended. The iodine nutrient is not enough among iodine deficiency disorder vulnerable population, especially in pregnant and lactation women. Infants growth development is retarded.
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Background and Objective Keshan disease is clinically characterized as a dilated eardiomyopathy. We analyze the prevalence trend during last decade of hypertension and Keshan-disease in Yangzhuang village which was a Keshan-disease epidemic area.Method The survey including medical history,blood pressure and ECG were carried out every two years during the follow up 13 years.Results During follow up period,the total detection rate(hypertension:13.4 % vs Keshan-disease:10.7 %,?~2=8.555,P=0.002)and the accumulative rate of hypertension were higher than those of Keshan-disease,which was on the contrary to that before 1993,when increasing rate of Keshan-disease was higher than hypertension.Furthermore,the accumulative increasing rate of hypertension was 240.0%,which was higher than the national average level during corresponding period with no significant differences between female and male.Conclusion The detection rate of hypertension in Keshan disease epidemic area was higher than the average rate nation-wide.Whether the hypertension prevalence was re- lated to Keshan-disease needs further investigation.